Patent RU-2770636-C1 (RU)
Title: Method for scleral fixation of polymer ophthalmological intracapsular ring in case of failure of the ligamentous apparatus of the lens
Inventor: Dibina Darya Andreevna
IPC: A61F9/007
Filed: 2021-08-12
Granted: 2022-04-19
Abstract: FIELD: medicine.SUBSTANCE: invention relates to medicine, namely ophthalmology. The main corneal incision, capsulorrhexis (CCC), is carried out, one end of the thread is passed in the area of the ciliary furrow using a guide needle, and the second end of the thread is passed through the loop of the stabilizing device and the formation of a flange. Next, centering of the stabilizing device is carried out, cutting off the end of the thread located at the sclera, heating the end of the thread with the formation of a flange using a thermal router. As a stabilizing device, an open polymer ophthalmic intracapsular ring (ICR) with loops at the ends with dimensions of 11, or 12, or 13 mm is used. After performing three or four corneal paracentesis, three or four iridocapsular retractors are installed. After removal of the lens masses, the capsule bag is filled with a viscoelastic preparation. After that, the end of the polypropylene thread is threaded through the hole of one of the ICR loops and melted with a thermoscauter to form a flange larger than the hole in the ICR loop. Then the ICR is inserted into the injector so that the loop with the flange is located at the entrance to the cavity of the injector, remove the iridocapsular retractor located in the lower segment. Next, the ICR is implanted into the capsule bag in such a way that both loops are located in the most dehiscent area of the ligamentous apparatus of the lens. In this case, the free end of the polypropylene thread is left in the main corneal incision, the thread is removed with a hook in the area of the lower paracentesis remaining after the removal of this iridocapsular retractor, forming an outer loop, while the free end of the thread is left in the anterior chamber. Then, the conjunctival flap is separated or the conjunctiva is moved away with microsurgical tweezers in the projection of the dehiscence zone of the ligamentous apparatus of the lens, after which a scleral tunnel is formed using a 27 or 30 G needle bent by 90°. The injection is made 2 mm from the limb in the area of the ciliary furrow, then the needle is passed through the equator of the capsule and gets into the capsule bag, using tweezers, the free end of the thread is inserted into the needle cavity and removed through the sclera. Next, a flange is formed, changing its shape to a “nail cap”, it is immersed in the scleral tunnel, then the remaining iridocapsular retractors are removed. After that, the posterior chamber IOL is implanted, the remaining stages of phacoemulsification are performed, in the case of the formation of a conjunctival flap, it is sutured.EFFECT: method makes it possible to achieve intraoperative restoration of the stability and integrity of the capsule sac, followed by the possibility of intra-capsule implantation of a posterior chamber IOL model and preserve the anatomical and physiological structure of the eyeball.1 cl, 4 dwg, 3 ex